Elevated pre-eclampsia risk in lupus nephritis and antiphospholipid syndrome: a nationwide Spanish registry analysis

Martín-Portugués, M; Esteban-Sampedro, J; Mellor-Pita, S; Tutor de Ureta, P; Fernández-Guitián, R; Huerta, A; Ruiz-Irastorza, G; Dueña-Bartolome, L; Royuela, A; Ortega-de la Puente, A; de la Cruz-Echeandía, M; Moreno-Torres, V

doi:10.1093/rheumatology/keaf484

Lupus & antiphospholipid syndrome

Elevated pre-eclampsia risk in lupus nephritis and antiphospholipid syndrome: a nationwide Spanish registry analysis

Rheumatology (Oxford)Published 14 Sep 2025Retrospective cohort study

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Authors' conclusion

The risk of PE and PESC that patients with SLE exhibit is further amplified in those with a history of LN or APS.

Study context

Population: Pregnant women admitted between 2016–2022, Spanish Hospital Discharge Database
Participants: 1,973,249 admissions

Exposure: SLE vs no SLE
SLEn = 1,787
Outcome: PE and PE with severity criteria (PESC: early-onset PE, severe PE, eclampsia, HELLP syndrome)

Methodological detailsnationwide, Spanish Hospital Discharge Database, adjusted analyses, Prior LN in 13.2% of SLE patients; SLE prevalence 9.1‰

Nationwide
Spanish Hospital Discharge Database
Adjusted analyses
Prior LN in 13.2% of SLE patients; SLE prevalence 9.1‰

Main finding

As reported in the abstract

SLE5.5%

Non-SLE2.1%

SLE with LN alone10.3%

SLE with LN and APS22.7%

Each group vs Non-SLEAdjusted odds ratio (95% CI)

SLEPE

1.78(1.39–2.28)

SLEPESC

2.17(1.47–3.22)

LNPE

1.94(1.18–3.19)

LNPESC

2.45(1.18–5.09)

APSPE

1.53(1.28–1.84)

APSPESC

1.91(1.44–2.54)

Observational data: associations, not effects.

Further findings

Factors linked to pre-eclampsia (PE) and PE with severity criteria (PESC) within SLE patients

	← Lower odds ←→ Higher odds →	OR (95% CI)
Baseline hypertensionPE · within SLE patients	0.10.31310	4.27 (2.45–7.44)
	0.10.31310Odds ratio (log scale)

Outcome	← Lower odds vs Non-SLE ←→ Higher odds vs Non-SLE →	OR (95% CI)
Factors linked to PE and PESC within SLE patientsLNvs Non-SLEPE · within SLE patients	0.20.5125	2.06 (1.26–3.37)
Factors linked to PE and PESC within SLE patientsAPSvs Non-SLEPE · within SLE patients	0.20.5125	1.85 (1.03–3.32)
Factors linked to PE and PESC within SLE patientsLNvs Non-SLEPESC; LN alone predicted PESC · within SLE patients	0.20.5125	2.88 (1.41–5.91)
	0.20.5125Odds ratio (log scale)

Original publication

Elevated pre-eclampsia risk in lupus nephritis and antiphospholipid syndrome: a nationwide Spanish registry analysis. Rheumatology (Oxford). Published 14 September 2025. doi:10.1093/rheumatology/keaf484

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